Youth Needs Screener Survey

A student self-assessment screening tool that screens internalizing needs and strengths.

To allow your student to complete the survey, please fill out the following form by clicking here. You will need to submit one form for each student.

Below are items to rate based on how you think, feel, and do. The information you give will be used to help determine your current strengths. Read each sentence and circle the best answer for how you felt in the past month.

Items to complete

Almost Never

Sometimes

Often

Almost Always

I feel nervous or afraid

1

2

3

4

I find it hard to relax or settle down

1

2

3

4

I get bothered by things that didn't bother me before

1

2

3

4

I have uncomfortable and tense feelings in my body

1

2

3

4

I feel like I'm going to panic or think I might lose control

1

2

3

4

I am not really enjoying doing anything anymore

1

2

3

4

I feel worthless or lonely when I'm around other people

1

2

3

4

I have headaches, stomach aches, or other pains

1

2

3

4

I am able to solve conflicts with others before they become bigger

1

2

3

4

I can take turns in conversations

1

2

3

4

I am able to establish relationships with others

1

2

3

4

I can control myself when I get excited or bored

1

2

3

4

I respect others' belongings and personal space

1

2

3

4

I am able to keep my things organized and easily find them when I need them

1

2

3

4

I can ignore distractions to stay focused on the task at hand

1

2

3

4

I am able to complete tasks on time

1

2

3

4